神经精神性狼疮性发作的危险因素

Risk factors of epileptic seizures in patients with neuropsychiatric systemic lupus erythematosus

目的探讨神经精神性狼疮(NPSLE)性发作的危险因素。方法回顾性分析86例NPSLE患者的临床特点,按照有无性发作,分为性发作组(n=37)和无性发作组(n=49)。采用单因素分析和多因素Logistic回归分析比较两组人口学特点及各临床指征的差异。结果单因素分析显示:两组患者的年龄、发病年龄、免疫抑制剂应用史、氯喹或羟氯喹应用史及抗心磷脂抗体存在统计学差异(P<0.05)。Logistic回归分析显示,发病年龄和既往氯喹或羟氯喹应用史是NPSLE性发作的独立影响因素(OR=0.361,P=0.047;OR=0.332,P=0.024)。结论未成年发病是NPSLE性发作的独立危险因素,既往使用氯喹或羟氯喹是其独立保护因素。

Objective To investigate the risk factors of epileptic seizures in patients with neuropsychiatric systemic lupus erythematosus（NPSLE）.Methods The clinical characteristics of 86 patients with NPSLE were retrospectively analysed.Patients were divided into epileptic seizure group（n=37） and non-epileptic seizure group（n=49）.Univariate analysis and multivariate Logistic regression analysis were performed to compare the demographic characteristics and clinical indications between two groups.Results Univariate analysis revealed that there were significant differences between two groups in age,age of systemic lupus erythematosus（SLE） onset,history of immunosuppressant use,history of hydroxychloroquine or chloroquine use and anticardiolipin antibodies（P0.05）.Logistic regression analysis indicated that age of SLE onset and history of hydroxychloroquine or chloroquine use were independent influencing factors for epileptic seizures of NPSLE（OR=0.361,P=0.047;OR=0.332,P=0.024）.Conclusion SLE onset before adulthood is an independent predictor of epileptic seizures,and history of hydroxychloroquine or chloroquine use is an independent protective factor.